PDF(Pubmed)
Abstract：
Intellectual disability (ID) commonly co-occurs in children with autism. Although diagnostic criteria for ID require impairments in both cognitive and adaptive functioning, most population-based estimates of the frequency of co-occurring ID in children with autism-including studies of racial and ethnic disparities in co-occurring autism and ID-base the definition of ID solely on cognitive scores. The goal of this analysis was to examine the effect of including both cognitive and adaptive behavior criteria on estimates of co-occurring ID in a well-characterized sample of 2- to 5-year-old children with autism. Participants included 3264 children with research or community diagnoses of autism enrolled in the population-based Study to Explore Early Development (SEED) phases 1-3. Based only on Mullen Scales of Early Learning (MSEL) composite cognitive scores, 62.9% (95% confidence interval [CI]: 61.1, 64.7%) of children with autism were estimated to have co-occurring ID. After incorporating Vineland Adaptive Behavior Scales, Second Edition (VABS-II) composite or domains criteria, co-occurring ID estimates were reduced to 38.0% (95% CI: 36.2, 39.8%) and 45.0% (95% CI: 43.1, 46.9%), respectively. The increased odds of meeting ID criteria observed for non-Hispanic (NH) Black and Hispanic children relative to NH White children when only MSEL criteria were used were substantially reduced, though not eliminated, after incorporating VABS-II criteria and adjusting for selected socioeconomic variables. This study provides evidence for the importance of considering adaptive behavior as well as socioeconomic disadvantage when describing racial and ethnic disparities in co-occurring ID in epidemiologic studies of autism.
摘要：
智力障碍（ID）通常在自闭症儿童中同时发生。尽管ID的诊断标准要求认知和适应性功能均受损，大多数基于人群的自闭症儿童共同发生ID的频率估计-包括对共同发生自闭症的种族和族裔差异的研究，以及ID的定义仅基于认知评分。这项分析的目的是研究在2至5岁自闭症儿童的特征明确的样本中，包括认知和适应性行为标准对共同发生的ID估计的影响。参与者包括3264名患有自闭症研究或社区诊断的儿童，他们参加了基于人群的探索早期发育研究（SEED）1-3阶段。仅基于Mullen早期学习量表(MSEL)复合认知得分，估计62.9%(95%置信区间[CI]:61.1%,64.7%)的自闭症儿童患有共同发生的ID。在纳入Vineland适应性行为量表后，第二版(VABS-II)复合或域标准，同时发生的ID估计降低到38.0%(95%CI：36.2，39.8%)和45.0%(95%CI：43.1，46.9%)，分别。当仅使用MSEL标准时，相对于NH白人儿童，观察到的非西班牙裔（NH）黑人和西班牙裔儿童符合ID标准的几率增加，虽然没有消除，在纳入VABS-II标准并针对选定的社会经济变量进行调整后。这项研究为在自闭症流行病学研究中描述共同发生的ID中的种族和种族差异时，考虑适应性行为以及社会经济劣势的重要性提供了证据。
